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Chapter 1

PSYC 328 Chapter Notes - Chapter 1: Graduate School, Psychosomatic Medicine, Biopsychosocial Model

Course Code
PSYC 328
Barbel Knauper

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Chapter 1 What is Health Psychology?
L01 What Is Health Psychology?
Health psychology: understanding psychological influence on
oHow people stay healthy
oWhy they become ill
oHow they respond when they get ill
Health psychologists study such issues and promote interventions to help people stay well/get over their
Health psychologists are concerned with all aspects of health and illness across the lifespan
Definition of health:
oWorld Health Organization (1948): complete state of physical, mental, and social well-being and
not merely the absence of disease or infirmity
oAchievement involving balance among physical, mental and social well-being
oInterchangeable with “wellness”
Goals of health psychology
oHealth promotion and maintenance
oPsychological aspects of the prevention and treatment of illness
oEtiology and correlated of health, illness and dysfunction
Etiology: origins/causes of illness
Interested in the behavioral and social factors that contribute to health or illness and
dysfunction, factors that can include health habits
oImpact of health institutions and health professionals on people’s behavior and develop
recommendations fro improving health care
Underlying these goals is a focus on understanding the behavioral factors involved in health and finding
effective theory and methods to change behaviors to reduce risks and optimize health
Health behaviors
oModifiable factors
oCan confer resilience or risk for the development of illness and help people maintain health and
manage disease
oCentral for understanding how health psychology can be useful for achieving each of these
important health-related goals
Health psychology represents:
1. Educational, scientific, professional contributions of psychology to the promotion and
maintenance of health
2. Prevention and treatment of illness
3. Identification of the causes and correlates of health and illness
4. Improvement of the health care system and the formulation of health policy
Treatment-related behaviors are important because they cut across several of the main themes of health
oScreening behaviors
oCare-seeking behaviors
oMaintenance and adherence behaviors
LO2 How Was Our View of the Mind-Body Relationship Changed Over Time?
Mind-body relationship: the same system or two separate ones?
We have come full circle in our beliefs about the mind-body relationship
Historical evolution of our understanding of the mind-body relationship
oEarliest times:
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Mind and body were considered a unit
Stone Age:
Disease arose when evil spirits entered the body and the spirits could be exorcised
through the treatment process
Ancient Greek:
Earliest civilizations to identify the role of bodily functioning in health and illness
Humoral theory of illness, proposed by Hippocrates, expanded by Galen:
oDisease arises when the four circulating fluids of the body (blood, black
bile, yellow bile, and phlegm) are out of balance
oFunction of treatment is to restore balance among the humors
oSpecific personality types were believed to be associated with bodily
temperaments in which one of the four humors predominated
oThey believe the factors can also have an impact on the mind
Middle Ages:
Supernatural explanations of illness
Mysticism and demonology, God’s punishment for evildoing
Church was the guardian of medical knowledge, medical practice took on
religious overtones
Unscientific generalizations about the body and the mind-body relationship
Healing and the practice of religion became indistinguishable
Patients’ thoughts and beliefs were viewed as central to changes in physical states
Imagination and emotions were seen as the means through which the individual
could connect with God, therefore implicated in both the genesis and remission of
In order to cure diseases, the physician needs to change the physical pathologies
as well as altering the imagination to induce body change.
Healing relied on unwavering and pure belief in the words and practices of the
oMind-body dualism:
Decartes’ doctrine of mind-body dualism
Medicine looked more to the medical laboratory and bodily factors, rather than to the
Breaking up the tasks between the physicians and the philosophers/theologians
Physical evidence became the sole basis for diagnosis and treatment of illness
Psychoanalytic Contributions
oRise of modern psychology: Sigmund Freud (1856-1939)
oConversion hysteria: specific unconscious conflicts can produce physical disturbances symbolic
of the repressed conflict (no longer a dominant view)
oPatients converts the conflict into a symptom via the voluntary nervous system
oHe or she the becomes relatively free of the anxiety the conflict would otherwise produce
oConversion reactions occurs via the voluntary nervious system with no necessary physiological
Psychosomatic Medicine
oFlanders Dunbar (1930s) and Franz Alexander (1940s)
oPsychosomatic medicine: a field within psychiatry, related to psychology; now used more
broadly to mean an approach to health-related problems and diseases that examines
psychological as well as somatic origins
oSpecific illnesses are produced by individuals’ internal conflicts
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oLinked patterns of personality rather than a single specific conflict to specific illnesses
oConflicts  anxiety  unconscious + takes a physiological toll on the body via automatic
nervous system  actual organic disturbance
oTheir works helped shape the emerging field of psychosomatic medicine by offer profiles to
particular disorders believed to be psychosomatic in origin (bodily disorders caused by emotional
oResearchers now believe that a particular conflict or personality type is not sufficient to produce
illness – the onset of disease requires the interaction of a variety of factors
Genetic weakness
Environmental stressors
Early/current ongoing learning experience and conflicts
Individual cognitions and coping effects
oLaid groundwork for a profound change in beliefs about the relation of the mind and the body
oBUT it relied on subjective, verbal interventions based on psychodynamic perspective – no
testable hypotheses
Behavioral Medicine
oGrowing popularity of cognitive behavioral approaches (1960s, 1970s)
oObservable and testable interventions for dealing with health and illness
oBehavioral medicine: interdisciplinary filed concerned with integrating behavioral science +
biomedical science of understanding physical health and illness and for developing and applying
knowledge and techniques to prevent, diagnose, treat and rehabilitate
To address this need by focusing on objective and clinically relevant interventions that
would demonstrate the mind-body connection suggested by psychosomatic medicine
Biofeeback: Behavioral Medicine (Birk, 1973) launched the filed of behavioral medicine
Current Views of the Mind-Body Relationship
oPhysical health is inextricably interwoven with the psychological and social environment
oAll conditions of health and illness, not just the disease identified by the early psychosomatic
theorists, are influenced by psychological and social factors
oTreatment of illness and prognosis for recovery are substantially affected by such factors as the
relationship between patient and practitioner, and expectations about pain and discomfort
oStaying well  good health habits  under personal control, socially determined factors: culture,
socio-economic status, place, stress, availability of health resources, social support
oGrowing interest in more holistic approaches to health and healing in Canada and other Western
countries (1990s in Canada)
E.g. Eastern and other alternative medical philosophies emphasize the interrelation of all
of the body’s systems + view illness as a disharmony between these systems
Healing through techniques and treatments that help to restore physical + psychological
balance: meditation, massage therapy, acupuncture, herbal remedies, homeopathy
Recognition of these approaches and integrate them into standard medical care
LO3 What Is The Biopsychosocial Model of Health?
Biopsychosocial model: the view that biological, psychosocial, and social factors are all involved in any
given state of health or illness
oFundamental assumption: health and illness are consequences of the interplay of biological,
psychological and social factors
The Biosychosocial Model versus the Biomedical Model
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